HomeMy WebLinkAbout20222982.tiffRESOLUTION
RE: APPROVE ACCEPTANCE OF PURCHASE ORDER FUNDS FOR 2021-2022
DISABILITY NAVIGATOR PROGRAM AND AUTHORIZE DEPARTMENT OF HUMAN
SERVICES TO DISBURSE FUNDS
WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to
Colorado statute and the Weld County Home Rule Charter, is vested with the authority of
administering the affairs of Weld County, Colorado, and
WHEREAS, the Board has been presented with a Purchase Order for the 2021-2022
Disability Navigator Program between the County of Weld, State of Colorado, by and through the
Board of County Commissioners of Weld County, on behalf of the Department of Human Services,
and the Colorado Department of Human Services, commencing September 1, 2021, and ending
June 30, 2022, with further terms and conditions being as stated in said purchase order, and
WHEREAS, after review, the Board deems it advisable to approve said purchase order, a
copy of which is attached hereto and incorporated herein by reference.
NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of
Weld County, Colorado, that the Purchase Order for the 2021-2022 Disability Navigator Program
between the County of Weld, State of Colorado, by and through the Board of County
Commissioners of Weld County, on behalf of the Department of Human Services, and the
Colorado Department of Human Services, be, and hereby is, approved.
BE IT FURTHER RESOLVED by the Board that the Purchase Order Funds, be, and
hereby are, accepted and the Department of Human Services, be, and hereby is, authorized to
disburse said funds.
The above and foregoing Resolution was, on motion duly made and seconded, adopted
by the following vote on the 26th day of October, A.D., 2022, nunc pro tunc September 1, 2021.
BOARD OF COUNTY COMMISSIONERS
WEL,P COUNTY, COLORADO
ATTEST: datifet) .. do;4,
Weld County Clerk to the Board
ounty Atto ney
Date of signature: I I / X2-2,
cc: HEb
11/i.122
SccEt K. James, Chair
2022-2982
HR0094
Cortivack IDatn35l
PRIVILEGED AND CONFIDENTIAL
MEMORANDUM
DATE: September 20, 2022
TO: Board of County Commissioners — Pass -Around
FR: Jamie Ulrich, Director, Human Services
RE: Disability Navigator Program Purchase Orders with the
Colorado Department of Human Services
Please review and indicate if you would like a work session prior to placing this item on the Board's
agenda.
Request Board Approval of the Department's Disability Navigator Program Purchase Orders with the
Colorado Department of Human Services. In 2019, the State passed HB 19-1223, creating the Disability
Navigator Program, which is overseen by the Department's Family Resource Division. The Disability Navigator
Program aims to help county residents with disabilities that are participating in the Aid to the Needy Disabled
State Only (AND -SO) program navigate the application and/or appeal process for federal disability benefits under
the Supplemental Security Income (SSI) program. The goals of the Program are to assist participants in
submitting timely and complete applications for SSI, increase the percentage of SSI approvals, reduce the time to
SSI approval, and reduce the time clients spend on the AND -SO program.
The Department received the following Purchase Orders to fund the program both in SFY 2022 and again for
SFY 2023.
CMS
SFY
Amount
PO Number
Term Date
6351
6352
2022
2023
$ 75,986.34
$ 109,453.52
PO, IHGA, 202200004299
PO,IHGA,202300001042
9/1/21 - 6/30/22
7/1/22 - 6/30/23
I do not recommend a Work Session. I recommend approval of these Purchase Orders and authorize the Family
Resource Division to dispense the Purchase Order funds as appropriate.
Approve Schedule
Recommendation Work Session Other/Comments:
Perry L. Buck
Mike Freeman, Pro-Tem
Scott K. James, Chair
Steve Moreno
Lori Saine
Pass -Around Memorandum; September 20, 2022 - CMS ID 6351 & 6352 Page 1
2022-2982
metocig
COLORADO
r of Economic Security
Employment Benefits
Director Jamie Ulrich
Weld County Human Services Department
315 N 11th Ave.
Greeley, CO 80631
September 1, 2021
Subject: Disability Navigator Program
Dear Director Ulrich:
Attached is the SFY22 fully executed Purchase Order (PO) between the State of Colorado
Department of Human Services (CDHS), Employment and Benefits Division (EBD) and Weld
County Human Services Department for Disability Navigation Services.
Work may begin immediately upon receipt of this letter and constitutes acceptance of the PO
and attached Exhibits. Your site will be paid through the County Fiscal Management System
(CFMS). It is the county's responsibility to submit expenses for the operation of the Disability
Navigator Program to CDHS monthly through CFMS code: P305.4890.
The following reports and documentation must be updated and/or submitted according to the
timeframes below. Please also maintain copies in the county records:
• Spending Report, submit within thirty days of the contract start date
• Data Et Evaluation Report, update via Google Sheet weekly by the Monday following
the prior week's work
• The Disability Navigation Services Referral form - maintained in the client's case file
The Disability Navigation Services Referral form is required to be sent to the Disability
Navigator at application for new Aid to the Needy State Only (AND -SO) applications once this
1575 Sherman Street, Denver CO 80203 F 303.868.5700 www.colorado.govicdhs
Jared Polls, Governor 1 Michelle Barnes,, Executive Director
contract is in place and services have started. For ongoing cases, the Disability Navigation
Services Referral for is required at the first recertification after services have started.
Counties may opt to contact ongoing cases prior to recertification to initiate services. Please
contact me if you'd like a list of active/ongoing cases to initiate services earlier than
recertification.
If you have any questions or need additional information, please contact Brenna Spang at
brenna.spang@state.co.us orat 303-827-5080.
Sincerely,
Brenna Spang, Disability Navigator Program Administrator
Colorado Department of Human Services
Division of Employment Et Benefits
1575 Sherman Street, 3rd floor
Denver, CO 80203
Cc:
Ian McMahon, Director, Employment and Benefits Division
Danielle Dunaway, Deputy Director, Employment and Benefits Division
Crickett Phelps, Manager, Benefits Et Services Section
Laura Sartor, Supervisor, Benefits Et Services Section
1575 Sherman Street, Denver C€3 80203 P 303.068 5700 wvrw.colorado.00v/`cr hs
Jared Polis, Governor J Michelle flames, Executive Director
STATE OF COLORADO
Department of Human Services
Number:
Date: 9/1/21
Description:
WELD AND -SO Disability Nav, SFY22
PO,IHGA,202200004299
Effective Date: 09/01/21
Ex $ iration Date: 06/30/22
Page 1 of 1
*****IMPORTANT*****
The order number and line number must appear on all
invoices, packing slips, cartons, and correspondence.
BILL TO
ACCOUNTING
1575 SHERMAN STREET, 6TH FLOOR
DENVER, CO 80203-1714
BUYER
SHIP TO
Buyer:
Email:
Toby Erxleben
toby.erxleben@state.co.us
ENDOR
WELD COUNTY
Human Services
PO BOX A
GREELEY, CO 80632
Contact:
Phone:
vendor contact
0000000000
SELF SUFFICIENCY--COLO WORKS
1575 SHERMAN STREET, 3RD FLOOR
DENVER, CO 80203-1714
HIPPING INSTRUCTIONS
Delivery/Install Date:
FOB:
ENDOR INSTRUCTIONS
XTENDED DESCRIPTION
HB 19-1223 Disability Navigator Program The Disability Navigator Program aims to help persons with
disabilities participating in the Stat AND -SO program navigate the application and/or appeal process for federal
disability benefits under the SSI program. The goals of the Disability Navigator Program are to assist participants
in submitting timely and complete applications for SSI and increase the percentage of SSI approvals, reduce the
time to SSI approval, and reduce the time clients spend on the AND -SO program.
Line Item
1
Commodity/Item Code UOM QTY Unit Cost Total Cost MSDS Req.
G1000 0 0.00 $75,986.34
Description: WELD SFY22 AND Navigator
■
Service From: 09/01/21
Service To: 06/30/22
TERMS AND CONDITIONS
https://www.colorado.gov/osc/purchase-order-terms-conditions
DOCUMENT TOTAL = $75.986.34
EXHIBIT A - STATEMENT OF WORK
1. ACRONYMS AND DEFINITIONS:
1.1 Aid to the Needy Disabled State Only (AND -SO): The AND -SO program provides
interim assistance to individuals aged 18-59 years who are disabled or blind but have
not been approved for Supplemental Security Income (SSI) or Social Security Disability
Insurance (SSDI).
1.2 Appeal: A request for Social Security to re-examine a claim for benefits. There are
four (4) levels of an appeal: Reconsideration, Hearing, Review, and Federal Court
Review.
1.3 Appointed Representative: When designated as an Appointed Representative, the
Disability Navigator may communicate with the Social Security Administration (SSA)
and Disability Determination Services (DDS) regarding the AND -SO Eligible
Participants' case. They may also access the claim file, with permission, designate
associates who perform administrative duties to receive information, provide evidence
or information to support the claim, request a reconsideration, a hearing, or an Appeals
Council Review, assist witness to prepare for a hearing, and receive copies of the
decisions made on the case. To appoint someone as an Appointed Representative,
form SSA -1696 shall be completed.
1.4 Client Facing Services: Services offered to clients in the Disability Navigator
Program.
1.5 Colorado Department of Human Services or CDHS: The Department responsible for
funding and overseeing the Disability Navigator Program. Referred to within this
Contract as the Department.
1.6 Complete Application: An application for SSI which contains all the information
necessary for SSA to make a determination of SSI eligibility. A Complete Application
shall include the SSA -16 Online Disability Benefit Application and may include
supporting medical opinions, medical records, and assessments, when available or
Form SSA -3373 Comprehensive Function Report.
1.7 Contractor: The county entity entering into this agreement with CDHS to provide
Disability Navigator Program services. Referred to within this contract as the
Contractor.
1.8 County Fiscal Management System (CFMS): The accounting system used to
process funds moving between counties and the state. The Contractor shall submit
expenses to CDHS through this system.
1.9 Disability: SSA defines "Disability" as the inability to engage in substantial gainful
activity because of a medically determinable physical or mental impairment(s) that has
Exhibit A- Statement of Work 1 of 10
lasted or is expected to last for a continuous period of at least 12 months OR is
expected to result in death.
1.10 Disability Determination Services (DDS): State agency charged with making
disability determinations.
1.11 Disability Navigator: An individual who assists the AND -SO client with applying for
and appealing to Social Security.
1.12 Disability Navigator Plan: This is the plan that the Contractor develops which
establishes how the Contractor shall develop, implement, and administer the Disability
Navigator Program.
1.13 Disability Navigator Program: Statewide program which aims to help persons with
disabilities participating in the State AND -SO program navigate the application and/or
appeal process for federal disability benefits under the SSI program.
1.14 Eligible Participant: An Eligible Participant is an individual that has applied for or is
receiving Aid to the Needy Disability State Only (AND -SO) in the county or region that is
administering the Disability Navigator Program.
1.15 Function Report: Form SSA -3373. This helps DDS to obtain information about how
an applicant's illness(es) and condition(s) affect their ability to function and perform
everyday tasks.
1.16 Participant Referral Form: State prescribed form that the Contractor uses to refer
the client to Disability Navigator services.
1.17 Pending Application: A completed application for SSI that has been submitted but
has not yet been determined eligible or ineligible.
1.18 Protected Filing Date: The date the applicant or Appointed Representative first
contacts SSA indicating an intent to file SSI and SSDI applications. This date is used
to determine when an individual may start receiving SSI benefits.
1.19 Social Security Administration (SSA): The SSA oversees the Supplemental
Security Income and Social Security Disability Insurance programs.
1.20 Social Security Disability Insurance (SSDI): Federal disability program
administered by SSA which provides benefits to blind or disabled individuals who are
"insured" based on contributions paid into Social Security.
1.21 Spending Report: This document outlines what the Disability Navigator
Program funds will be used for.
1.22 SSI/SSDI Outreach, Access, and Recovery (SOAR) Certified: SOAR is a program
Exhibit A- Statement of Work 2 of 10
through the Substance Abuse and Mental Health Services Administration (SAMHSA)
that is designed to assist SSI & SSDI applicants apply for benefits. SOAR Certified
means a person has received training and certification through the SOAR program.
1.23 Substantial Gainful Activity (SGA): The performance of significant physical and/or
mental activities in work for pay or profit, or in work of a type generally performed for
pay or profit, regardless of the legality of the work. "Significant activities" are useful in
the accomplishment of a job or the operation of a business, and have economic value.
Work may be substantial even if it is performed on a part-time basis, or even if the
individual does less, is paid less, or has less responsibility than in previous work. Work
activity is gainful if it is the kind of work usually done for pay, whether in cash or in kind
or for profit, whether or not a profit is realized. Activities involving self -care, household
tasks, unpaid training, hobbies, therapy, school attendance, clubs, social programs,
etc. are not generally considered to be SGA.
1.24 Supplemental Security Income (SSI): A needs based federal income supplement
program designed to help aged, blind, and disabled people who have little or no income.
2. OBJECTIVE
The purpose of this contract is to implement the Disability Navigator Program. The
Disability Navigator Program is a statewide program that aims to help persons with
disabilities participating in the State AND -SO program navigate the application and/or
appeal process for federal disability benefits under the SSI program. The goals of the
Disability Navigator Program are to assist Eligible Participants in submitting timely
and complete applications for SSI, increase the percentage of SSI approvals, reduce
the time to SSI approval, and reduce time on AND -SO.
3. SCOPE
A. Disability Navigator Plan. The Contractor shall develop a comprehensive plan for
how they will develop, implement, and administer the Disability Navigator Program.
The Disability Navigator Plan shall include the method the Contractor intends to use to
monitor the status of the SSI Application. The Department may work collaboratively
with the Contractor to strengthen the plan. The Contractor shall incorporate any
changes required by the State.
B. Eligible Participants. An Eligible Participant is an individual who has applied for or
is receiving AND -SO benefits. The Eligible Participant may or may not have an
application with SSA prior to participating in the Disability Navigator Program.
a. Eligible Participants may choose to participate with the Disability Navigator
Program.
i. The Eligible Participant may choose to work with a Disability Navigator
when a referral is offered at the County in which they apply for AND -SO.
Exhibit A- Statement of Work 3 of 10
ii. The Eligible Participant may withdraw from the Disability Navigator
Program at any time.
b. The Contractor shall use the Department prescribed Participant Referral Form to
verify participant eligibility for AND -SO. A copy of the form shall be retained in the
case file.
c. Disability Navigator Program services shall be offered to each Eligible Participant
that the Contractor is serving.
C. Recruiting and Enrollment of Eligible Participants.
a. The Contractor shall provide onboarding services immediately following a
referral and begin the process to match an Eligible Participant to correct
Disability Navigator Program services. Onboarding services may include:
i. Establishing contact with the client
ii. Making contact with local SSA office regarding the referral
iii. Working with the State Disability Specialist to establish a plan
b. The maximum time between referral and uptake of services shall be no more
than seven (7) calendar days.
D. Allowable Spending. Under no circumstances shall funds be used for capitol
construction. The Contractor may spend Disability Navigator funds in the following
ways:
a. Staff Disability Navigator Program Service Activities
i. Meeting with Disability Navigator Program clients. This may be over
the phone, virtually, or in person.
ii. Building the SSA claim for application.
iii. Preparing the SSA claim for Reconsideration, Hearing, Review, or
Federal Court Review.
iv. Corresponding with SSA and DDS.
v. Travel to and from client homes and service providers.
b. Staff Training
i. Disability Navigators may obtain training and/or certification to assist
AND -SO clients in applying for SSA benefits.
ii. Expenses related to training.
iii. Building a working relationship with the local SSA office.
c. Client Facing Services
i. Referrals to relevant licensed medical providers whose assessments
are required for the SSA application.
ii. Outreach to Disability Navigator Program clients to provide reminders
and track progress on SSA applications and appeals.
iii. Assistance in obtaining medical records.
iv. Transportation to necessary appointments.
Exhibit A- Statement of Work 4 of 10
E. Client Facing Services. Contractors shall ensure that the following services are
offered to clients in the Disability Navigator Program. Client Facing Services provided
may vary for each client depending on their SSI application status. Stages of applying
for SSI benefits include application, post application (ongoing), and appealing decisions
made by SSA.
a. Protected Filing Date. All applicants to the Disability Navigator Program shall
receive a Protected Filing Date within fifteen (15) calendar days from the date of
referral to Disability Navigator Program services.
b. Application Packet/Applications for SSI/SSDI. The Contractor shall ensure that
applications made with the Disability Navigator are complete. Upon submission
of the application packet, the Disability Navigator may receive a receipt to place
in the Client File. The application shall include:
i. A complete application shall consist of:
1. Online Disability Benefit Application (SSA -16)
ii. Optional documents to include with the application:
1. Appointment of Representative
2. Authorization to Disclose Information to SSA
3. Application for SSI (if not completed online)
4. Adult Disability Report
5. All relevant medical records
6. All supporting documentation
iii. Disability Navigator Program Client Facing Services that may be made
available to clients who have not applied to SSI yet and do not have a
current pending SSI applications:
1. Assistance developing a complete, thorough, and quality
application for SSI benefits when requested by the client and/or
serving as the client's Appointed Representative with the SSA.
2. Assistance submitting the application for SSI benefits when
requested by the client and/or serving as the client's Appointed
Representative with the SSA.
c. After an application has been submitted. Once the complete application has
been submitted, the Contractor shall create a method to monitor the status of the
application at least monthly. This plan shall include routine communications with
SSA and DDS. Routine communication shall be no less than once a month, and
may be verbal or written. The first communication should occur no more than five
(5) business days after the application has been submitted.
i. Disability Navigator Program Client Facing Services that may be made
available to clients who have a pending SSI application, are denied SSI,
or who are appealing a denial through SSA, Client Facing Services
provided shall include:
1. Provide prompt response to SSA and DDS inquiries, within ten (10)
calendar days of the inquiry.
2. Outreach to the client as needed to stay connected throughout the
determination process.
3. Assistance filing reconsiderations and/or appeals of federal
Exhibit A- Statement of Work 5 of 10
disability benefits when requested by the client.
d. Appeals. If the AND -SO client receives a denial from Social Security and wishes
to appeal the decision, the Contractor shall ensure that the Disability Navigator
Program completes a timely appeal. This appeal shall include all necessary
supporting documentation, including the SSA Appeal Form (SSA -561).
i. Disability Navigator Program Client Facing Services that may be made
available to clients that are in appeal include:
1. Prompt response to SSA and DDS inquiries within ten (10)
calendar days of the inquiry.
2. Ongoing outreach with the client during the process.
3. Assistance filing reconsiderations and/or appeals of federal
disability benefits when requested by the client.
e. Ongoing Disability Navigator Program Client Facing Services that shall be made
available to all AND -SO applicants and recipients may include:
i. The Disability Navigator may serve as the client's Appointed
Representative for interactions with SSA.
ii. Communicate as needed with SSA and DDS regarding the status of
applicants' claims.
iii. Writing a comprehensive function report and gathering supporting medical
opinions when available.
iv. Participating in the SSA interview process.
v. Making referrals to appropriate medical providers and other professionals
whose assessments are required as part of an application for federal
disability benefits.
vi. Collecting medical records, assessments, case management notes and
collateral information.
vii. Appointment coordination with doctors, therapists, SSA, etc.
F. Regionalized Approach. The Contractor shall have the option of serving a region
with the Disability Navigator Program. In order to successfully serve a region, the
Contractor shall serve the designated County Economic Assistance programs for that
region, and may include community partners, and SSA offices. If a regionalized
approach is used, the Contractor shall designate which County will serve as the fiscal
agent.
G. Relationship with Social Security. The Contractor shall make a reasonable effort
to build and maintain a working relationship with the Social Security office in the
region that the program is operated in. The Contractor shall notify the Department if
they are unable to establish a relationship or receive timely responses from the local
SSA office. Some examples of making a reasonable effort include:
a. Having consistent, ongoing, scheduled meetings on a quarterly basis, at
minimum.
b. Appointing a contact person to send and receive all communication with the SSA
office.
H. Case Files and Documentation. The Contractor shall maintain a detailed case file
Exhibit A- Statement of Work 6 of 10
for each Eligible Participant. This file may be paper or electronic. It shall contain medical
documents, SSA application and/or appeals, other documents used in the application,
Client Facing Services provided to assist with application, and all relevant outcomes
including the date of the approved SSI application. The Eligible Participant case file shall
be used to monitor the performance of the Contractor in meeting program and contract
objectives.
4. PERSONNEL REQUIREMENTS
A. Personnel General Requirements. The Contractor shall provide sufficient
personnel to perform the work described in this Contract. In the event that the
Department determines that the Contractor has provided insufficient staff or staff that
does not have the necessary skills, knowledge or experience to perform the work, the
Contractor shall provide additional and replacement staff to perform its obligations
under this Contract.
a. The Contractor shall maintain appropriate staffing levels throughout the term of
the contract.
B. Ongoing Training Requirements For Staff Offering Disability Navigator
services. The Contractor shall ensure that Disability Navigator Program services are
provided by people that are not disqualified or suspended from acting as an Appointed
Representative with the SSA and are not prohibited by any law from acting as an
Appointed Representative. The Contractor shall ensure that Disability Navigators
regularly attend State mandated training. Disability Navigators may also demonstrate a
level of expertise with the SSA application and appeal process through any of the
following:
a. Being an attorney licensed in Colorado or licensed to appear in any U.S. federal
court, in good standing;
b. Obtaining or having SOAR certification;
c. Receiving adequate training by a licensed attorney or SOAR certified person and
having submitted at least ten applications to the SSA in the past year; or
d. Other certifications or experience approved by the Department in writing or
electronically.
C. Subcontracting. There is no contractual relationship between subcontractors
and the Department. The contractual relationship exists only between the Contractor
and the Department, between whom there is "privity of contract."
a. CDHS shall manage the Contractor's performance according to the terms
agreed upon in this Exhibit A, Statement of Work.
b. The Contractor may choose to subcontract with another agency, organization, or
individual to serve as the employer of record. Any subcontractors shall be
specified and submitted to the Department for approval prior to beginning work.
c. The Contractor shall not change subcontractors without consultation with and
Exhibit A- Statement of Work 7 of 10
approval from the Department.
d. The Contractor shall report on subcontractor activities as a part of their monthly
reporting requirements. Billing for subcontracted work shall be included as a part
of the Contractor's Spending Report submission.
5. MONITORING, DATA TRACKING, REPORTING, AND EVALUATION
A. Data Collection: The Contractor shall collect the following data on each client
served through the Disability Navigator Program:
a. Demographics (Name, date of birth, SSN, education level)
b. SSI/SSDI application status and history
c. Type of disability
d. Income
e. Resources
f. Medical or mental health treatment history, including inpatient treatment
g. Housing Status (homeless, housed)
h. Work history
i. length, industry, physical intensity
i. Date and description of each and all Client Facing Services received
from the Disability Navigator (e.g., outreach, securing a protected filing
date, appointment coordination with the health care provider(s),
response to DDS inquiry)
j. Dates when applications are submitted to SSA
k. Dates of any communication from (and with) SSA and DDS
I. Start and End Date as of which the Disability Navigator serves as the
Appointed Representative with SSA (if applicable)
B. Reporting: The Contractor shall collect and track program data and provide
Eligible Participant information and Spending Reports to CDHS monthly. Once
developed, the Contractor will enter appropriate demographic, service, and event
information directly into the Statewide Automated System (Colorado Benefits
Management System (CBMS)).
C. Evaluation:
a. Formal evaluation of the Disability Navigator Program is required by the state
legislature. The Department shall provide evaluation, either through internal
Department resources, or by contracting with an outside entity. The Contractor
shall comply with all requirements needed to complete this evaluation, including
timely data entry into a project database.
b. The Department may conduct informal evaluations of the Contractor. This may
occur at least once during the contract's terms. Additionally, the Department has
the right to inspect the Contractor's records at any reasonable time, in order to
assure compliance with and performance of the terms of the contract and its
Statement of Work. Any amounts the Contractor paid improperly shall be
Exhibit A- Statement of Work 8 of 10
immediately returned to the Department or may be recovered in accordance with
other remedies.
6. BUDGET/ ALLOCATION
A. Allocation. The Department shall allocate appropriated funds based on the
most recent annual AND -SO caseload data.
B. Spending Report. The Contractor shall develop a Spending Report in collaboration
with the Department. The sum total in the Spending Report for an allocation period
shall not exceed the total budget. The Department may make recommended changes
to the Spending Report based on experience with overseeing the Disability Navigator
Program.
a. The final Spending Report template shall be submitted within 30 days of the
contract effective date.
b. After the Spending Report is finalized, line item shifts that result in a change to
the percentage of funding expended on direct services require pre -approval
from the Department.
i. The Contractor shall submit changes to the Spending Report via email or
written notice to the Department.
ii. The Department shall review written requests for deviations from the the
approved Spending Report within 7 business days and respond to the
request within 14 business days. All change requests shall be based on
actual or projected data. The Department may approve or deny requests.
C. Spending Process.The Contractor shall develop a process that ensures
spending and considers redistribution of funds to maximize successful execution of
the Disability Navigator Program.
D. Supplantation. The Contractor shall not use Disability Navigator Program funds to
supplant other contracts/programs.
7. COMPENSATION, INVOICES, AND PAYMENT
A. Compensation. The Contractor shall be paid no more than the maximum amount
outlined on the contract cover page or purchase order document.
a. All reimbursements shall be made on a cost -reimbursable basis, based on actual
expenditures.
B. Invoicing. The Contractor shall invoice the Department on a monthly basis, by the
18th business day of the month following the month for which the invoice covers.
a. The Contractor shall use the Spending Report as the approved invoice.
b. The Contractor shall deliver the final Spending Report for each fiscal year by
the seventh calendar day of July.
Exhibit A- Statement of Work 9 of 10
c. The Department reserves the right to disapprove all or part of any costs of
services that are not included in the contract.
d. If additional source documentation is required by the Department to clarify
expenditures, it will be requested. The Contractor shall have 5 business days
to provide the information and/or documentation requested.
e. The Contractor shall be notified in email or writing by the Department of
exception to payments.
C. Payments. In addition to the Spending Report, the Contractor shall submit for
payment of expenses incurred monthly through the County Fiscal Management
System (CFMS).
a. The amount submitted for payment through CFMS shall coincide with
expenses outlined in the Spending Report.
b. Submission of expenses to CFMS, and subsequent payment, does not
constitute acceptance of the by the Department and shall not imply the
acceptance or sufficiency of any work performed or deliverables submitted.
c. The Department may work with the Contractor to clarify or correct any
payments submitted through CFMS.
d. The Department is not obligated to remit payment to the Contractor if they
fail to submit their final expenses into CFMS by the seventh calendar day of
July.
8. DUTIES AND OBLIGATIONS OF THE DEPARTMENT
A. The Department shall notify the Contractor of any changes to State regulations
governing the program.
B. The Department shall consult with and provide the Contractor with data collection
requirements.
C. The Department shall review spending levels, including actual and encumbered by
the Contractor as compared to their initial amount of funding.
a. The Department shall determine whether the Contractor is spending at a pace
that will allow them to meet their budget and participation estimates. The
contract may be amended to reallocate funds accordingly.
D. The Department may increase or decrease the quantity of goods/services
described in section/schedule/exhibit based upon the rates established in the
contract.
Exhibit A- Statement of Work 10 of 10
EXHIBIT B - BUDGET
WELD COUNTY
BUDGET YEAR - SFY 2022
Contract Effective Date THROUGH June 30, 2022
.
BUDGET
DETAIL
TOTAL
Program
client
administation
Program
AND
facing
service
for
program.
services
Eligible
of
activites,
the
necessary
Disability
Participants
staff
training,
Navigator
for
in
the
state
and
$ 75,986.34
-SO
GRAND
TOTAL
$ 75,986.34
EXHIBIT C - HIPAA BUSINESS ASSOCIATE AGREEMENT
This HIPAA Business Associate Agreement ("Agreement") between the State and Contractor is agreed to in
connection with, and as an exhibit to, the Contract. For purposes of this Agreement, the State is referred to as
"Covered Entity" and the Contractor is referred to as "Business Associate". Unless the context clearly requires a
distinction between the Contract and this Agreement, all references to "Contract" shall include this Agreement.
1. PURPOSE
Covered Entity wishes to disclose information to Business Associate, which may include Protected Health
Information ("PHI"). The Parties intend to protect the privacy and security of the disclosed PHI in compliance
with the Health Insurance Portability and Accountability Act of 1996 ("HIPAA"), Pub. L. No. 104-191 (1996) as
amended by the Health Information Technology for Economic and Clinical Health Act ("HITECH Act") enacted
under the American Recovery and Reinvestment Act of 2009 ("ARRA") Pub. L. No. 111-5
(2009), implementing regulations promulgated by the U.S. Department of Health and Human Services at 45
C.F.R. Parts 160, 162 and 164 (the "HIPAA Rules") and other applicable laws, as amended. Prior to the
disclosure of PHI, Covered Entity is required to enter into an agreement with Business Associate containing
specific requirements as set forth in, but not limited to, Title 45, Sections 160.103, 164.502(e) and 164.504(e) of
the Code of Federal Regulations ("C.F.R.") and all other applicable laws and regulations, all as may be amended.
2. DEFINITIONS
The following terms used in this Agreement shall have the same meanings as in the HIPAA Rules: Breach, Data
Aggregation, Designated Record Set, Disclosure, Health Care Operations, Individual, Minimum Necessary,
Notice of Privacy Practices, Protected Health Information, Required by Law, Secretary, Security Incident,
Subcontractor, Unsecured Protected Health Information, and Use.
The following terms used in this Agreement shall have the meanings set forth below:
a. Business Associate. "Business Associate" shall have the same meaning as the term "business
associate" at 45 C.F.R. 160.103, and shall refer to Contractor.
b. Covered Entity. "Covered Entity" shall have the same meaning as the term "covered entity" at 45
C.F.R. 160.103, and shall refer to the State.
c. Information Technology and Information Security. "Information Technology" and "Information
Security" shall have the same meanings as the terms "information technology" and "information
security", respectively, in §24-37.5-102, C.R.S.
Capitalized terms used herein and not otherwise defined herein or in the HIPAA Rules shall have the meanings
ascribed to them in the Contract.
3. OBLIGATIONS AND ACTIVITIES OF BUSINESS ASSOCIATE
a. Permitted Uses and Disclosures.
i. Business Associate shall use and disclose PHI only to accomplish Business Associate's
obligations under the Contract.
Page 1 of 9
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i. To the extent Business Associate carries out one or more of Covered Entity's obligations
under Subpart E of 45 C.F.R. Part 164, Business Associate shall comply with any and all
requirements of Subpart E that apply to Covered Entity in the performance of such obligation.
ii. Business Associate may disclose PHI to carry out the legal responsibilities of Business
Associate, provided, that the disclosure is Required by Law or Business Associate obtains
reasonable assurances from the person to whom the information is disclosed that:
A. the information will remain confidential and will be used or disclosed only as
Required by Law or for the purpose for which Business Associate originally
disclosed the information to that person, and;
B. the person notifies Business Associate of any Breach involving PHI of which it is
aware.
iii. Business Associate may provide Data Aggregation services relating to the Health Care
Operations of Covered Entity. Business Associate may de -identify any or all PHI created or
received by Business Associate under this Agreement, provided the de -identification
conforms to the requirements of the HIPAA Rules.
b. Minimum Necessary. Business Associate, its Subcontractors and agents, shall access, use, and
disclose only the minimum amount of PHI necessary to accomplish the objectives of the Contract, in
accordance with the Minimum Necessary Requirements of the HIPAA Rules including, but not
limited to, 45 C.F.R. 164.502(b) and 164.514(d).
c. Impermissible Uses and Disclosures.
i. Business Associate shall not disclose the PHI of Covered Entity to another covered entity
without the written authorization of Covered Entity.
ii. Business Associate shall not share, use, disclose or make available any Covered Entity PHI in
any form via any medium with or to any person or entity beyond the boundaries or
jurisdiction of the United States without express written authorization from Covered Entity.
d. Business Associate's Subcontractors.
Business Associate shall, in accordance with 45 C.F.R. 164.502(e)(1)(ii) and 164.308(b)(2),
ensure that any Subcontractors who create, receive, maintain, or transmit PHI on behalf of
Business Associate agree in writing to the same restrictions, conditions, and requirements that
apply to Business Associate with respect to safeguarding PHI.
ii. Business Associate shall provide to Covered Entity, on Covered Entity's request, a list of
Subcontractors who have entered into any such agreement with Business Associate.
iii. Business Associate shall provide to Covered Entity, on Covered Entity's request, copies of
any such agreements Business Associate has entered into with Subcontractors.
e. Access to System. If Business Associate needs access to a Covered Entity Information Technology
system to comply with its obligations under the Contract or this Agreement, Business Associate shall
request, review, and comply with any and all policies applicable to Covered Entity regarding such
Page 2 of 9
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system including, but not limited to, any policies promulgated by the Office of Information
Technology and available at http://oit.state.co.us/about/policies.
f Access to PHI. Business Associate shall, within ten days of receiving a written request from Covered
Entity, make available PHI in a Designated Record Set to Covered Entity as necessary to satisfy
Covered Entity's obligations under 45 C.F.R. 164.524.
g.
Amendment of PHI.
Business Associate shall within ten days of receiving a written request from Covered Entity
make any amendment to PHI in a Designated Record Set as directed by or agreed to by
Covered Entity pursuant to 45 C.F.R. 164.526, or take other measures as necessary to satisfy
Covered Entity's obligations under 45 C.F.R. 164.526.
ii. Business Associate shall promptly forward to Covered Entity any request for amendment of
PHI that Business Associate receives directly from an Individual.
h. Accounting Rights. Business Associate shall, within ten days of receiving a written request from
Covered Entity, maintain and make available to Covered Entity the information necessary for
Covered Entity to satisfy its obligations to provide an accounting of Disclosure under 45 C.F.R.
164.528.
i. Restrictions and Confidential Communications.
J.
i. Business Associate shall restrict the Use or Disclosure of an Individual's PHI within ten days
of notice from Covered Entity of:
A. a restriction on Use or Disclosure of PHI pursuant to 45 C.F.R. 164.522; or
B. a request for confidential communication of PHI pursuant to 45 C.F.R. 164.522.
ii. Business Associate shall not respond directly to an Individual's requests to restrict the Use or
Disclosure of PHI or to send all communication of PHI to an alternate address.
iii. Business Associate shall refer such requests to Covered Entity so that Covered Entity can
coordinate and prepare a timely response to the requesting Individual and provide direction to
Business Associate.
Governmental Access to Records. Business Associate shall make its facilities, internal practices,
books, records, and other sources of information, including PHI, available to the Secretary for
purposes of determining compliance with the HIPAA Rules in accordance with 45 C.F.R. 160.310.
k. Audit, Inspection and Enforcement.
Business Associate shall obtain and update at least annually a written assessment performed
by an independent third party reasonably acceptable to Covered Entity, which evaluates the
Information Security of the applications, infrastructure, and processes that interact with the
Covered Entity data Business Associate receives, manipulates, stores and distributes. Upon
request by Covered Entity, Business Associate shall provide to Covered Entity the executive
summary of the assessment.
Page 3 of 9
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ii. Business Associate, upon the request of Covered Entity, shall fully cooperate with Covered
Entity's efforts to audit Business Associate's compliance with applicable HIPAA Rules. If,
through audit or inspection, Covered Entity determines that Business Associate's conduct
would result in violation of the HIPAA Rules or is in violation of the Contract or this
Agreement, Business Associate shall promptly remedy any such violation and shall certify
completion of its remedy in writing to Covered Entity.
1. Appropriate Safeguards.
i. Business Associate shall use appropriate safeguards and comply with Subpart C of 45 C.F.R.
Part 164 with respect to electronic PHI to prevent use or disclosure of PHI other than as
provided in this Agreement.
ii. Business Associate shall safeguard the PHI from tampering and unauthorized disclosures.
iii. Business Associate shall maintain the confidentiality of passwords and other data required for
accessing this information.
iv. Business Associate shall extend protection beyond the initial information obtained from
Covered Entity to any databases or collections of PHI containing information derived from
the PHI. The provisions of this section shall be in force unless PHI is de -identified in
conformance to the requirements of the HIPAA Rules.
m. Safeguard During Transmission.
Business Associate shall use reasonable and appropriate safeguards including, without
limitation, Information Security measures to ensure that all transmissions of PHI are
authorized and to prevent use or disclosure of PHI other than as provided for by this
Agreement.
ii. Business Associate shall not transmit PHI over the internet or any other insecure or open
communication channel unless the PHI is encrypted or otherwise safeguarded with a FIPS-
compliant encryption algorithm.
Reporting of Improper Use or Disclosure and Notification of Breach.
Business Associate shall, as soon as reasonably possible, but immediately after discovery of a
Breach, notify Covered Entity of any use or disclosure of PHI not provided for by this
Agreement, including a Breach of Unsecured Protected Health Information as such notice is
required by 45 C.F.R. 164.410 or a breach for which notice is required under §24-73-103,
C.R.S.
ii. Such notice shall include the identification of each Individual whose Unsecured Protected
Health Information has been, or is reasonably believed by Business Associate to have been,
accessed, acquired, or disclosed during such Breach.
iii. Business Associate shall, as soon as reasonably possible, but immediately after discovery of
any Security Incident that does not constitute a Breach, notify Covered Entity of such
incident.
Page 4 of 9
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iv. Business Associate shall have the burden of demonstrating that all notifications were made as
required, including evidence demonstrating the necessity of any delay.
Business Associate's Insurance and Notification Costs.
i. Business Associate shall bear all costs of a Breach response including, without limitation,
notifications, and shall maintain insurance to cover:
A. loss of PHI data;
B. Breach notification requirements specified in HIPAA Rules and in §24-73-103,
C.R.S.; and
C. claims based upon alleged violations of privacy rights through improper use or
disclosure of PHI.
ii. All such policies shall meet or exceed the minimum insurance requirements of the Contract
or otherwise as may be approved by Covered Entity (e.g., occurrence basis, combined single
dollar limits, annual aggregate dollar limits, additional insured status, and notice of
cancellation).
iii. Business Associate shall provide Covered Entity a point of contact who possesses relevant
Information Security knowledge and is accessible 24 hours per day, 7 days per week to assist
with incident handling.
iv. Business Associate, to the extent practicable, shall mitigate any harmful effect known to
Business Associate of a Use or Disclosure of PHI by Business Associate in violation of this
Agreement.
Subcontractors and Breaches.
Business Associate shall enter into a written agreement with each of its Subcontractors and
agents, who create, receive, maintain, or transmit PHI on behalf of Business Associate. The
agreements shall require such Subcontractors and agents to report to Business Associate any
use or disclosure of PHI not provided for by this Agreement, including Security Incidents and
Breaches of Unsecured Protected Health Information, on the first day such Subcontractor or
agent knows or should have known of the Breach as required by 45 C.F.R. 164.410.
ii. Business Associate shall notify Covered Entity of any such report and shall provide copies of
any such agreements to Covered Entity on request.
Data Ownership.
i. Business Associate acknowledges that Business Associate has no ownership rights with
respect to the PHI.
ii. Upon request by Covered Entity, Business Associate immediately shall provide Covered
Entity with any keys to decrypt information that the Business Association has encrypted and
maintains in encrypted form, or shall provide such information in unencrypted usable form.
Page 5 of 9
HIPAA BAA
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r. Retention of PHI. Except upon termination of this Agreement as provided in Section 5, below,
Business Associate and its Subcontractors or agents shall retain all PHI throughout the term of this
Agreement, and shall continue to maintain the accounting of disclosures required under Section 3.h,
above, for a period of six years.
4. OBLIGATIONS OF COVERED ENTITY
a. Safeguards During Transmission. Covered Entity shall be responsible for using appropriate
safeguards including encryption of PHI, to maintain and ensure the confidentiality, integrity, and
security of PHI transmitted pursuant to this Agreement, in accordance with the standards and
requirements of the HIPAA Rules.
b. Notice of Changes.
Covered Entity maintains a copy of its Notice of Privacy Practices on its website. Covered
Entity shall provide Business Associate with any changes in, or revocation of, permission to use
or disclose PHI, to the extent that it may affect Business Associate's permitted or required uses
or disclosures.
ii. Covered Entity shall notify Business Associate of any restriction on the use or disclosure of
PHI to which Covered Entity has agreed in accordance with 45 C.F.R. 164.522, to the extent
that it may affect Business Associate's permitted use or disclosure of PHI.
5. TERMINATION
a. Breach.
In addition to any Contract provision regarding remedies for breach, Covered Entity shall
have the right, in the event of a breach by Business Associate of any provision of this
Agreement, to terminate immediately the Contract, or this Agreement, or both.
ii. Subject to any directions from Covered Entity, upon termination of the Contract, this
Agreement, or both, Business Associate shall take timely, reasonable, and necessary action to
protect and preserve property in the possession of Business Associate in which Covered
Entity has an interest.
b. Effect of Termination.
i. Upon termination of this Agreement for any reason, Business Associate, at the option of
Covered Entity, shall return or destroy all PHI that Business Associate, its agents, or its
Subcontractors maintain in any form, and shall not retain any copies of such PHI.
ii. If Covered Entity directs Business Associate to destroy the PHI, Business Associate shall
certify in writing to Covered Entity that such PHI has been destroyed.
iii. If Business Associate believes that returning or destroying the PHI is not feasible, Business
Associate shall promptly provide Covered Entity with notice of the conditions making return
or destruction infeasible. Business Associate shall continue to extend the protections of
Page 6 of 9
HIPAA BAA
Revised August 2018
Section 3 of this Agreement to such PHI, and shall limit further use of such PHI to those
purposes that make the return or destruction of such PHI infeasible.
6. INJUNCTIVE RELIEF
Covered Entity and Business Associate agree that irreparable damage would occur in the event Business
Associate or any of its Subcontractors or agents use or disclosure of PHI in violation of this Agreement, the
HIPAA Rules or any applicable law. Covered Entity and Business Associate further agree that money damages
would not provide an adequate remedy for such Breach. Accordingly, Covered Entity and Business Associate
agree that Covered Entity shall be entitled to injunctive relief, specific performance, and other equitable relief to
prevent or restrain any Breach or threatened Breach of and to enforce specifically the terms and provisions of this
Agreement.
7. LIMITATION OF LIABILITY
Any provision in the Contract limiting Contractor's liability shall not apply to Business Associate's liability under
this Agreement, which shall not be limited. This requirement shall not be interpreted to create any indemnification
obligation on behalf of Contractor.
8. DISCLAIMER
Covered Entity makes no warranty or representation that compliance by Business Associate with this Agreement
or the HIPAA Rules will be adequate or satisfactory for Business Associate's own purposes. Business Associate
is solely responsible for all decisions made and actions taken by Business Associate regarding the safeguarding of
PHI.
9. CERTIFICATION
Covered Entity has a legal obligation under HIPAA Rules to certify as to Business Associate's Information
Security practices. Covered Entity or its authorized agent or contractor shall have the right to examine Business
Associate's facilities, systems, procedures, and records, at Covered Entity's expense, if Covered Entity
determines that examination is necessary to certify that Business Associate's Information Security safeguards
comply with the HIPAA Rules or this Agreement.
10. AMENDMENT
a. Amendment to Comply with Law. The Parties acknowledge that state and federal laws and
regulations relating to data security and privacy are rapidly evolving and that amendment of this
Agreement may be required to provide procedures to ensure compliance with such developments.
i. In the event of any change to state or federal laws and regulations relating to data security
and privacy affecting this Agreement, the Parties shall take such action as is necessary to
implement the changes to the standards and requirements of HIPAA, the HIPAA Rules
and other applicable rules relating to the confidentiality, integrity, availability and
security of PHI with respect to this Agreement.
ii. Business Associate shall provide to Covered Entity written assurance satisfactory to
Covered Entity that Business Associate shall adequately safeguard all PHI, and obtain
Page 7 of 9
HIPAA BAA
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written assurance satisfactory to Covered Entity from Business Associate's
Subcontractors and agents that they shall adequately safeguard all PHI.
iii. Upon the request of either Party, the other Party promptly shall negotiate in good faith the
terms of an amendment to the Contract embodying written assurances consistent with the
standards and requirements of HIPAA, the HIPAA Rules, or other applicable rules.
iv. Covered Entity may terminate this Agreement upon 30 days' prior written notice in the event
that:
A. Business Associate does not promptly enter into negotiations to amend the Contract
and this Agreement when requested by Covered Entity pursuant to this Section; or
B. Business Associate does not enter into an amendment to the Contract and this
Agreement, which provides assurances regarding the safeguarding of PHI sufficient,
in Covered Entity's sole discretion, to satisfy the standards and requirements of the
HIPAA, the HIPAA Rules and applicable law.
b. Amendment of Appendix. The Appendix to this Agreement may be modified or amended by the
mutual written agreement of the Parties, without amendment of this Agreement. Any modified or
amended Appendix agreed to in writing by the Parties shall supersede and replace any prior version
of the Appendix.
11. ASSISTANCE IN LITIGATION OR ADMINISTRATIVE PROCEEDINGS
Covered Entity shall provide written notice to Business Associate if litigation or administrative proceeding is
commenced against Covered Entity, its directors, officers, or employees, based on a claimed violation by
Business Associate of HIPAA, the HIPAA Rules or other laws relating to security and privacy or PHI. Upon
receipt of such notice and to the extent requested by Covered Entity, Business Associate shall, and shall cause its
employees, Subcontractors, or agents assisting Business Associate in the performance of its obligations under the
Contract to, assist Covered Entity in the defense of such litigation or proceedings. Business Associate shall, and
shall cause its employees, Subcontractor's and agents to, provide assistance, to Covered Entity, which may
include testifying as a witness at such proceedings. Business Associate or any of its employees, Subcontractors or
agents shall not be required to provide such assistance if Business Associate is a named adverse party.
12. INTERPRETATION AND ORDER OF PRECEDENCE
Any ambiguity in this Agreement shall be resolved in favor of a meaning that complies and is consistent with the
HIPAA Rules. In the event of an inconsistency between the Contract and this Agreement, this Agreement shall
control. This Agreement supersedes and replaces any previous, separately executed HIPAA business associate
agreement between the Parties.
13. SURVIVAL
Provisions of this Agreement requiring continued performance, compliance, or effect after termination shall
survive termination of this contract or this agreement and shall be enforceable by Covered Entity.
Page 8 of 9
HIPAA BAA
Revised August 2018
APPENDIX TO HIPAA BUSINESS ASSOCIATE AGREEMENT
This Appendix ("Appendix") to the HIPAA Business Associate Agreement ("Agreement") is s an appendix to the
Contract and the Agreement. For the purposes of this Appendix, defined terms shall have the meanings ascribed
to them in the Agreement and the Contract.
Unless the context clearly requires a distinction between the Contract, the Agreement, and this Appendix, all
references to "Contract" or "Agreement" shall include this Appendix.
1. PURPOSE
This Appendix sets forth additional terms to the Agreement. Any sub -section of this Appendix marked as
"Reserved" shall be construed as setting forth no additional terms.
2. ADDITIONAL TERMS
a. Additional Permitted Uses. In addition to those purposes set forth in the Agreement, Business
Associate may use PHI for the following additional purposes:
i. Reserved.
b. Additional Permitted Disclosures. In addition to those purposes set forth in the Agreement, Business
Associate may disclose PHI for the following additional purposes:
i. Reserved.
c. Approved Subcontractors. Covered Entity agrees that the following Subcontractors or agents of
Business Associate may receive PHI under the Agreement:
i. Reserved.
d. Definition of Receipt of PHI. Business Associate's receipt of PHI under this Contract shall be
deemed to occur, and Business Associate's obligations under the Agreement shall commence, as
follows:
i. Reserved.
e. Additional Restrictions on Business Associate. Business Associate agrees to comply with the
following additional restrictions on Business Associate's use and disclosure of PHI under the
Contract:
i. Reserved.
f. Additional Terms. Business Associate agrees to comply with the following additional terms under the
Agreement:
i. Reserved.
Page 9 of 9
HIPAA BAA
Revised August 2018
Chloe White
From:
Sent:
To:
Cc:
Subject:
Attachments:
Hi Chloe,
Alison Pegg
Thursday, October 20, 2022 1:14 PM
Chloe White; HS -Contract Management
Cheryl Hoffman; Esther Gesick; Houstan Aragon
RE: Contract ID #6351 PO for Disability Navigator Program
Weld Transmittal letter FY22.pdf
This item isn't associated with any previous Tyler ID. We do have the attached Transmittal letter that is associated with
it, I'm not sure if that helps provide any information that could be useful while creating the Reso. A bill in 2019 began
the program, but because of the pandemic it took some time for the program to actually get funded by the State. The
State offered funding for Disability Navigators for all counties via an interest survey sent to DHS Directors, which
resulted in the attached transmittal letter and PO that is in CMS.
This PO, CMS ID 6351 is for SFY 2022 which our team didn't become aware of until late August. Also as an FYI, CMS ID
6352 is also now routing through CMS for approval which is for the same program, but for SFY 2023.
Please let me know if you need any additional information.
Thanks!
Alison Pegg
Contract Management and Compliance Coordinator
Weld County Dept. of Human Services
315 N. 11th Ave., Bldg A
PO Box A
Greeley, CO 80632
fit (970) 400-6603
Contract Management Extension: 6556
A (970) 353-5212
®apegg(&,,weldgov.com
Confidentiality Notice: This electronic transmission and any attached documents or other writings are intended only for the
person or entity to which it is addressed and may contain information that is privileged, confidential or otherwise protected from disclosure. If you
have received this communication in error, please immediately notify sender by return e-mail and destroy the communication. Any disclosure,
copying, distribution or the taking of any action concerning the contents of this communication or any attachments by anyone other than the
named recipient is strictly prohibited.
From: Chloe White <cwhite@weldgov.com>
Sent: Thursday, October 20, 2022 12:42 PM
To: HS -Contract Management <HS-ContractManagement@co.weld.co.us>
Cc: Cheryl Hoffman <choffman@weldgov.com>; Esther Gesick <egesick@weldgov.com>; Houstan Aragon
<haragon@weldgov.com>
Subject: Contract 10 96351 PO for Disability Navigator Program
Good afternoon,
In regards to the Purchase Order for the Disability Navigator program, do you know what the Tyler # is for the
application?
Thank you,
Chloe A. White
Deputy Clerk to the Board Supervisor
Weld County Clerk to the Board's Office
1150 0 Street
Greeley, CO 80631
Tel: (970) 400-4213
Email: cwhite(aweldgov.com
Confidentiality Notice: This electronic transmission and any attached documents or other writings are intended
only for the person or entity to which it is addressed and may contain information that is privileged, confidential
or otherwise protected from disclosure. If you have received this communication in error, please immediately
notify sender by return e-mail and destroy the communication. Any disclosure, copying, distribution or the
taking of any action concerning the contents of this communication or any attachments by anyone other than
the named recipient is strictly prohibited.
2
Contract Form
New Co
Ent: Information
Entity Name* Entity ID*
COLORADO DEPARTMENT OF HUMAN O40603650
SERVICES
Contract Name"
COLORADO DEPARTMENT OF HUMAN SERVICES (DISABILITY
NAVIGATOR PROGRAM PO IHGA,202200004299)
Contract Status
CTB REVIEW
❑ New Entity?
Contract ID
6351
Contract Lead
APEGG
Contract Lead Email
apeggOweldgov.com; cabbx
xlknreldgov.com.
Parent Contract ID
Requires Board Approval.
YES
Department Project
Contract Description"
PO IS FOR THE SFY 22. TERM DATES: 9i1 /21-6/30x'22. AMOUNT: $75,986.34. OVERSEEN BY THE FAMILY RESOURCE
DIVISION. THE DISABILITY NAVIGATOR PROGRAM AIMS TO HELP PERSONS WITH DISABILITIES PARTICIPATING IN THE STAT
AND -SO PROGRAM.
Contract Description 2
PA IS BEING ROUTED THROUGH THE NORMAL PROCESS. ETA TO CTB 9122/22.
Contract Type
AGREEMENT
Amount*
$ 75,986.34
Renewable"
NO
Automatic Renewal
Grant
Department
HUMAN SERVICES
Department Email
CM-
HumanService s due Idgov.co
Department Head Email
CM-HurnanServices-
De ptHeadOweldgvv.cam
County Attorney
GENERAL COUNTY
ATTORNEY EMAIL
County Attorney Email
CM-
COUNTYA.TTOR N EYA'WELDG
OV.COM
Requested ROCC Agenda
Date"
09/28/2022
Due Date
09/24/2022
Will a work session with BOCC be required?*
NO
Does Contract require Purchasing Dept. to be included?
If this is a renewal enter previous Contract ID
If this is part of a NSA enter MSA Contract ID
Note: the Previous Contract Number and Master Services Agreement Number should be left blank if those contracts are not in
OnBase
Con
Effective Date
Termination. Notice Period
Contact Name
Contact Type
Contact Email
Contact Phone 1
Contact Phone 2
Purchasing
Purchasing Approver
Approval Process
Department Head
JAMIE ULRICH
DH Approved Date
10/17/2022
al
BOCC Approved
BOCC Signed Date
BOCC Agenda Date
10/26/2022
Final Appri
Originator
APEGG
Review Date.
04"29"2022
Committed Delivery Date
Finance Approver
CHERYL PATTELLI
Renewal Date
Expiration Date*
06,"30;`2022
Purchasing Approved Date
Finance Approved Date
10/18 /2022
Tyler Ref #
AG 102622
Legal Counsel
BRUCE BARKER
Legal Counsel Approved Date
10;18"2022
Hello